陈泓志 梁伟林 顾瞻 张慧卿

    摘要 程序性细胞死亡蛋白-1及其配体(PD-1/PD-L1)抑制剂可引发与既往治疗手段不同的免疫相关不良反应。根据中医基础理论及药性理论的相关知识，尝试对PD-1/PD-L1抑制剂进行中药化性能分析，认为PD-1/PD-L1抑制剂的药物性能属辛温之品，趋向升浮，归于肺、脾、胃经，其免疫相关不良反应的主要病因为“免疫药毒”，主要病机为风邪兼杂湿邪与热毒合阻于肌肤，脾胃虚弱以及气血亏虚，并提出了相应的治法，以期对免疫治疗的临床疗效及安全性的提升起到积极作用。

    关键词 免疫治疗;免疫相关不良反应;病因分析;病机分析;中药性能

    Abstract Programmed cell death-1 and its ligand (PD-1/PD-L1) inhibitors could cause immune-related adverse reactions different from previous treatments. According to the relevant knowledge of traditional Chinese medicine (TCM) basic theories and medicinal property theories， we try to analyze the Chinese herbal properties of PD-1/PD-L1 inhibitors and think that they are warm in four qi and pungent in five flavors， have the ascending and floating nature， and enter the lung， spleen and stomach meridians. The main etiology of immune-related adverse reactions is “immune drug toxicity”. The main pathogenies respectively are the exogenous pathogenic wind with dampness and heat toxicity which blocks the skin， the deficiency of spleen and stomach and the deficiency of qi and blood. Also， we propose the corresponding treatments in order to improve the clinical efficacy and safety of immunotherapy. ......